Chapter 7: Connective Tissue Lesions

Test Bank
MULTIPLE CHOICE
1. Peripheral fibromas are seen exclusively in which of the following intraoral sites?
a. Lip
b. Buccal mucosa
c. Palate
d. Tongue
e. Gingiva
ANS: E

REF: Chap 7 (Peripheral fibroma/Clinical features), p 163

2. Pseudoepitheliomatous hyperplasia is a frequent microscopic finding of a neuralderived benign tumor in which granular cells expand submucosa. This lesion is
known as:
a. Traumatic neuroma
b. Neurofibroma
c. Neurilemmoma
d. Leiomyoma
e. None of the above
ANS: E

REF: Chap 7 (Granular cell tumors/Histopathology), p 176

3. Nifedipine-induced gingival hyperplasia may be confused clinically with all the

following except:
a. Dilantin-induced hyperplasia
b. MEN III
c. Idiopathic gingival hyperplasia
d. Leukemic infiltrates of gingiva
e. Generalized gingival hyperplasia associated with local factors
ANS: B
REF: Chap 7 (Mucosal neuromas of multiple endocrine neoplasia syndrome type
III), pp 180-181
4. Which of the following is known to behave in a clinically aggressive fashion and have
a significant recurrence rate?
a. Schwannoma
b. Granular cell tumor
c. Neurofibroma
d. Fibromatosis
e. Monomorphic adenoma
ANS: D

REF: Chap 7 (Fibromatosis), pp 170-171

5. Cells found in the congenital epulis of the newborn are identical or nearly identical to
cells making up which of the following tumors?
a. Neurilemmoma
b. Peripheral giant cell granuloma
Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

Test bank

c. Mixed tumor
d. Granular cell tumor
e. None of the above
ANS: D

REF: Chap 7 (Granular cell tumors/Etiology), pp 175-176

6. A 54-year-old woman developed an asymptomatic 1 1 cm nodule in her buccal

mucosa. An excisional biopsy was done and was described microscopically as a
circumscribed mass of dense collagen and fibroblasts. This would be a:
a. Pyogenic granuloma
b. Peripheral fibroma
c. Focal fibrous hyperplasia
d. Neurofibroma
e. Papilloma
ANS: C

REF: Chap 7 (Focal fibrous hyperplasia), pp 164-165

7. Trauma or irritation is believed to be the cause of all the following except:

a. Papillary hyperplasia
b. Mucous extravasation phenomenon
c. Peripheral fibroma
d. Pyogenic granuloma
e. Neurofibroma
ANS: E

REF: Chap 7 (Neurofibroma/Etiology), p 178

8. A 1 1 cm pedunculated lesion of the gingiva of a 3-month-old girl was described

microscopically as being composed of granular cells covered by thin epithelium. This
describes which of the following?
a. Peripheral fibroma
b. Dysplastic oral wart
c. Gingival cyst
d. Neuroectodermal tumor of infancy
e. Congenital granular cell tumor
ANS: E

REF: Chap 7 (Granular cell tumors/Etiology), pp 175-176

9. A significant risk of malignant transformation is associated with which of the

following?
a. Papillary hyperplasia
b. Peripheral ossifying fibroma
c. Squamous papilloma
d. Focal epithelial hyperplasia (Hecks disease)
e. None of the above
ANS: E
REF: Chap 6 (Papillary hyperplasia; Squamous papilloma/oral wart/Focal epithelial
hyperplasia), pp 149-154 | Chap 7 (Peripheral fibroma), pp 163-164
10. Pain is often a characteristic clinical feature of which of the following lesions?

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

Test bank
a.
b.
c.
d.
e.

Squamous papilloma
Pyogenic granuloma
Palatal papillomatosis
Traumatic fibroma
Traumatic neuroma

ANS: E

REF: Chap 7 (Traumatic neuroma/Clinical features), p 175

11. Acute leukemias, especially monocytic leukemias, may cause oral manifestations of
bleeding and:
a. Generalized gingival hyperplasia
b. Mucous extravasation
c. Focal lymphoid hyperplasia
d. Melanosis
e. All the above
ANS: A
166

REF: Chap 7 (Generalized gingival hyperplasia/Etiology), p

12. The condition in which a patient may develop caf-au-lait macule patches on skin and
mucocutaneous neurofibromas is known as:
a. Gorlins syndrome
b. MEN III
c. Neurofibromatosis
d. Melanoma
e. None of the above
ANS: C
179

REF: Chap 7 (Caf-au-lait macules/Clinical features), pp 178-

13. Reactive hyperplasias:

a. Are relatively rare in dental patients
b. Are etiologically associated with immunodeficiency
c. Represent an overexuberant repair process
d. Are caused by Candida albicans
e. All the above
ANS: C

REF: Chap 7 (Reactive hyperplasias), pp 163-167

14. A 16-year-old girl had an asymptomatic 2 3 cm crepitant mass in her tongue. It was
slightly lighter in color than the surrounding tissue. Biopsy showed numerous
endothelial-lined channels. This is a:
a. Granular cell tumor
b. Ranula
c. Mucocele
d. Lymphangioma
e. Lymphoma
ANS: D

REF: Chap 7 (Lymphangioma/Clinical features), p 174

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

Test bank

15. Mucosal plexiform neuromas, pheochromocytomas, and thyroid medullary

carcinomas are components of which of the following syndromes?
a. Peutz-Jeghers syndrome
b. MEN III
c. Addisons disease
d. von Recklinghausens disease of skin
e. Sjgrens syndrome
ANS: B
REF: Chap 7 (Mucosal neuromas of multiple endocrine neoplasia syndrome type
III), pp 180-181
16. Pseudoepitheliomatous hyperplasia is a microscopic phenomenon that mimics
squamous cell carcinoma microscopically and is frequently associated with which of
the following?
a. Peripheral giant cell granuloma
b. Peripheral fibroma
c. Congenital epulis of the newborn
d. Pyogenic granuloma
e. Granular cell tumor
ANS: E

REF: Chap 7 (Granular cell tumors/Box 7-6), pp 175-177

17. Oral reactive hyperplasias:

a. Represent premalignant processes
b. Are caused by overgrowth of oral bacterial flora
c. Represent preneoplastic processes
d. Are relatively common in dental patients
e. All the above
ANS: D

REF: Chap 7 (Reactive hyperplasias), pp 163-167

18. A 16-year-old patient complained of a 1 1 cm nontender mass in his upper lip. The
lesion was nonulcerated and was composed of a dilated duct containing a sialolith.
This would be which of the following?
a. Focal fibrous hyperplasia
b. Traumatic neuroma
c. Fibromatosis
d. Mucous extravasation phenomenon
e. None of the above
ANS: E
REF: Chap 7 (Focal fibrous hyperplasia/Traumatic neuroma/Fibromatosis), pp 164165, 170-171, 175 | Chap 8 (Mucous extravasation phenomenon), pp 187-188
19. A firm asymptomatic lump measuring 1 1 cm was discovered in the mandibular
gingiva of a 32-year-old woman. The mass was well defined, firm, and the same color
as the surrounding tissue. Which of the following would be most likely?
a. Granular cell tumor
b. Peripheral fibroma

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

Test bank

c. Necrotizing sialometaplasia
d. Salivary gland tumor
e. Pyogenic granuloma
ANS: B

REF: Chap 7 (Peripheral fibroma), pp 163-164

20. An oral biopsy was taken from the tongue of a 36-year-old woman and was
interpreted as a leiomyoma. This is a:
a. Benign neoplasm of smooth muscle
b. Malignant neoplasm of skeletal muscle
c. Reactive hyperplasia
d. Benign tumor of salivary gland origin
e. Congenital lesion of lymphatic vessels
ANS: A

REF: Chap 7 (Leiomyoma and leiomyosarcoma), pp 182-183

21. All the following occur predominantly in the gingiva except:

a. Peripheral giant cell granuloma
b. Peripheral fibroma
c. Congenital epulis of the newborn
d. Pyogenic granuloma
e. Neurofibroma
ANS: E

REF: Chap 7 (Neurofibroma/Etiology), p 178

22. Generalized gingival hyperplasia may be associated with ingestion of which of the
following drugs?
a. Ibuprofen
b. Aspirin
c. Nifedipine
d. Penicillin
e. Tetracycline
ANS: C

REF: Chap 7 (Generalized gingival hyperplasia), pp 166-167

23. All the following could be classified as oral reactive fibrous hyperplasia except:
a. Traumatic fibroma
b. Peripheral fibroma
c. Fibromatosis
d. Generalized gingival hyperplasia
e. Denture-induced hyperplasia
ANS: C

REF: Chap 7 (Fibromatosis), pp 170-171

24. Peripheral ossifying fibromas are lesions that occur exclusively in which of the
following sites?
a. Ramus of the mandible
b. Lips
c. Tongue
d. Palate

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

Test bank

e. None of the above

ANS: E

REF: Chap 7 (Peripheral fibroma), pp 163-164

25. A biopsy of a painful nodule from the soft tissue adjacent to the mental foramen
showed the presence of mixture of both hyperplastic nerve tissue and scar. This is
indicative of:
a. Nodular fasciitis
b. Traumatic neuroma
c. Peripheral fibroma
d. Granular cell tumor
e. Neurofibroma
ANS: B

REF: Chap 7 (Traumatic neuroma/Etiology), p 175

26. Denture-induced fibrous hyperplasia that is associated with the flanges of poorly
fitting dentures is characteristically seen in what location?
a. Retromolar pad
b. Buccal mucosa
c. Lateral border of the tongue
d. Anterior vestibular mucosa
e. Hard palate
ANS: D
REF: Chap 7 (Denture-induced fibrous hyperplasia/Clinical features), p 165
27. All the following represent connective tissue reactions to injury except:
a. Pyogenic granuloma
b. Traumatic neuroma
c. Peripheral ossifying fibroma
d. Lymphangioma
e. Peripheral fibroma
ANS: D

REF: Chap 7 (Lymphangioma), pp 173-174

28. Risk of malignant transformation is associated with which of the following, when
occurring as multiple lesions, in conjunction with pigmented patches of the skin?
a. Lipoma
b. Neurofibroma
c. Granular cell tumor
d. Traumatic fibroma
e. Traumatic neuroma
ANS: B

REF: Chap 7 (Neurofibroma/Clinical features), pp 178-179

29. The Schwann cell is the cell of origin for which of the following tumors?
a. Leiomyoma
b. Rhabdomyoma
c. Neurilemmoma
d. Mixed tumor

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

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e. None of the above

ANS: C

REF: Chap 7 (Schwannoma/Etiology), p 177

30. Granular cell tumors of the adult have a predilection for which of the following sites?
a. Gingiva
b. Upper lip
c. Lower lip
d. Tongue
e. Buccal mucosa
ANS: D

REF: Chap 7 (Granular cell tumors/Clinical features), p 176

31. A 24-year-old man presented with the second recurrence of a buccal mucosa mass.
The lesion was composed of fibrous connective tissue and was cytologically benign.
However, it was nonencapsulated and freely infiltrated surrounding soft tissue. This
lesion suggests which of the following?
a. Fibromatosis
b. Traumatic fibroma
c. Reactive hyperplasia
d. Pyogenic granuloma
e. Hyperplastic scar
ANS: A

REF: Chap 7 (Fibromatosis/Histopathology), p 171

32. Surgical excision is the treatment of choice for which of the following?
a. Traumatic fibroma
b. Traumatic neuroma
c. Granular cell tumor
d. Neurofibroma
e. All the above
ANS: E
REF: Chap 7 (Focal fibrous hyperplasia/Traumatic neuroma/Granular cell
tumors/Neurofibroma), pp 164-165, 175-180
33. A 20-year-old patient, who has been taking sodium dilantin for seizure control,
develops a marked increase in the bulk of his attached gingiva. If the change is, in
fact, drug related, which of the following features would dominate the microscopic
picture?
a. Epithelial hyperplasia
b. Generalized gingival hyperplasia
c. Malignant leukocytes
d. Abundant nerve tissue
e. Sebaceous hyperplasia
ANS: B
REF: Chap 7 (Generalized gingival hyperplasia/Box 7-2), pp 166-167

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

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34. Which of the following disorders places the patient at risk for the appearance or
development of a malignancy?
a. Primary Sjgrens syndrome
b. Proliferative verrucous leukoplakia
c. Neurofibromatosis
d. MEN III
e. All the above
ANS: E
REF: Chap 3 (Preneoplastic and neoplastic lesions), pp 90-95 | Chap 7
(Neurofibroma/Mucosal neuromas of MEN III), pp 178-181 | Chap 8 (Sjgrens
syndrome), pp 196-199
35. The granular cell tumor is often surfaced by epithelium showing:
a. Pseudoepitheliomatous hyperplasia
b. Atrophy
c. Acantholysis
d. Ulceration
e. None of the above
ANS: A

REF: Chap 7 (Granular cell tumors/Histopathology), p 176

36. Conservative surgical excision would be appropriate treatment, and probably curative,
for which of the following?
a. Nodular fasciitis
b. Fibromatosis
c. Fibrosarcoma
d. Rhabdomyosarcoma
e. Adenoid cystic carcinoma
ANS: A

REF: Chap 7 (Nodular fasciitis/Treatment), p 170

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.